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乳腺癌和多种疾病预防减肥项目与书面建议对参加乳腺癌家族史诊所的女性的随机对照试验。

Randomised controlled trial of breast cancer and multiple disease prevention weight loss programmes vs written advice amongst women attending a breast cancer family history clinic.

机构信息

The Prevent Breast Cancer Research Unit, The Nightingale Centre, Manchester University NHS Foundation Trust, Manchester, M23 9LT, England.

NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, England.

出版信息

Br J Cancer. 2023 May;128(9):1690-1700. doi: 10.1038/s41416-023-02207-z. Epub 2023 Feb 25.

Abstract

BACKGROUND

Overweight and obesity are common amongst women attending breast cancer Family History, Risk and Prevention Clinics (FHRPCs). Overweight increases risk of breast cancer (BC) and conditions including cardiovascular disease (CVD) and type-2 diabetes (T2D). Clinics provide written health behaviour advice with is likely to have minimal effects. We assessed efficacy of two remotely delivered weight loss programmes vs. written advice.

METHOD

210 women with overweight or obesity attending three UK FHRPCs were randomised to either a BC prevention programme (BCPP) framed to reduce risk of BC (n = 86), a multiple disease prevention programme (MDPP) framed to reduce risk of BC, CVD and T2D (n = 87), or written advice (n = 37). Change in weight and health behaviours were assessed at 12-months.

RESULTS

Weight loss at 12 months was -6.3% (-8.2, -4.5) in BCPP, -6.0% (-7.9, -4.2) in MDPP and -3.3% (-6.2, -0.5) in the written group (p = 0.451 across groups). The percentage losing ≥10% weight in these groups were respectively 34%, 23% and 14% (p = 0.038 across groups).

DISCUSSION

BCPP and MDPP programmes resulted in more women achieving ≥10% weight loss, but no evidence of additional benefits of MDPP. A multicentre RCT to test the BCPP across UK FHRPCs is warranted. Clinical Trial Registration ISRCTN16431108.

摘要

背景

超重和肥胖在参加乳腺癌家族史、风险和预防诊所(FHRPC)的女性中很常见。超重会增加乳腺癌(BC)的风险,以及包括心血管疾病(CVD)和 2 型糖尿病(T2D)在内的疾病风险。诊所提供书面健康行为建议,但效果可能微乎其微。我们评估了两种远程提供的减肥计划与书面建议相比的效果。

方法

210 名超重或肥胖的女性参加了英国的三个 FHRPC,他们被随机分配到乳腺癌预防计划(BCPP)组(n=86)、多种疾病预防计划(MDPP)组(n=87)或书面建议组(n=37)。在 12 个月时评估体重和健康行为的变化。

结果

12 个月时,BCPP 组体重减轻 6.3%(-8.2,-4.5),MDPP 组体重减轻 6.0%(-7.9,-4.2),书面组体重减轻 3.3%(-6.2,-0.5)(组间差异无统计学意义)。在这些组中,体重减轻≥10%的百分比分别为 34%、23%和 14%(组间差异有统计学意义)。

讨论

BCPP 和 MDPP 计划使更多的女性达到了≥10%的体重减轻,但没有证据表明 MDPP 有额外的益处。需要在英国的 FHRPC 中进行多中心 RCT 来测试 BCPP。临床试验注册号 ISRCTN83554245。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6b2/10133277/b3ea56916d79/41416_2023_2207_Fig1_HTML.jpg

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